0:00

We are now going to shift from the inflammatory disease

0:04

to benign neoplasms.

0:06

There are numerous types of benign neoplasms

0:09

that may populate the cyan nasal cavity,

0:11

and we're going to touch on several of them.

0:14

The ones that are associated

0:15

with the bone obviously would be your osteos,

0:17

and those are most common.

0:19

You can have conroy lesion, particularly

0:22

of the nasal septum, and those would be our KDRs.

0:25

Occasionally we would have malignancies including

0:28

chondro sarcomas.

0:29

The characteristic benign neo imp plasm

0:32

of the cyan nasal cavity is the inverted papilloma.

0:34

This is a type of Schneider papilloma.

0:37

It's the most common type of Schneider in papilloma.

0:40

There are other types, including oncotic

0:42

and exophytic papillomas,

0:44

but we're gonna mostly emphasize inverted papilloma.

0:48

You can have minor salivary gland tumors just

0:51

as there are minor salivary glands throughout the

0:54

aerodigestive system.

0:55

There are minor salivary glands in the sino nasal cavity,

0:59

and the most common of the benign neoplasms is

1:01

polymorphic adenoma.

1:03

There's a new entity

1:04

that has been described in the WHO classification

1:07

of Cy nasal benign neoplasms,

1:10

and those include respiratory epithelial adenoid hematomas.

1:14

You will see the abbreviation, REAH.

1:18

These are benign tumors that are associated with patients

1:21

who may have cy nasal polyposis or allergic polyposis.

1:25

They usually occur along the posterior nasal septum

1:28

and they look effectively like polyps.

1:31

But are these benign hematomas neoplasms?

1:36

Here is a patient who has a characteristic osteo

1:41

osteos occur most commonly in the frontal sinus

1:43

and in the ethmoid sinus, less commonly in maxillary

1:47

and sphenoid science.

1:48

And you see the very characteristic bony density associated

1:52

with the CT scan,

1:55

and in this case, extending from the frontal sinus

1:58

into the nasal cavity.

2:00

How would these look on MRI scan?

2:02

Well, as you can see on this T one weighted MR

2:05

and T two weighted mr.

2:06

It may fool you because there is no hydrogen water

2:11

protons in this case, in the bone, and

2:15

therefore it's going to effectively look like aeration,

2:18

but it is actually an pacified sinus,

2:21

and this may be best seen on post gadolinium enhanced scans

2:25

where you would see peripheral enhancement of the mucosa

2:29

around the osteo.

2:31

But as you can see, this is another potential pitfall of

2:36

MRI in that the dark signal of the bone

2:39

simulates the dark signal of aerated perinasal sinus.

2:44

A nice example of osteo on CT as well as Mr.